Differential diagnosis of myelographic changes

Myeloid changes can occur in a variety of lesions, and each disease that will have myeloid changes will have a different bone marrow image. The following is an introduction to several different types of bone marrow image changes. 1. Bone marrow image of aplastic anemia Bone marrow hypoplasia or severe hypoplasia, decreased percentage of volume of hematopoietic and adipose tissue (Vol%) (less than 34Vol%), increased fat cells and stroma. Erythrocytes and granulocytes are reduced, megakaryocytes are significantly reduced or missing, lymphocytes are relatively increased, and non-hematopoietic cells such as plasma cells, mast cells, and reticulocytes are increased. 2. Bone marrow picture of megaloblastic anemia Bone marrow proliferation is extremely active, the area of hematopoietic tissue is greater than or equal to 90Vol%, and adipocytes are reduced. There is diffuse infiltration of megaloblasts at different stages of development, and the granulocyte/red ratio is reduced. 3. Bone marrow picture of iron deficiency anemia Bone marrow proliferation is obviously active or extremely active, with hematopoietic tissue area of 50~89Vol% (or higher), predominantly erythropoietic cells at different developmental stages, and decreased granulocyte/red ratio. Proliferation of middle and late juvenile erythrocytes was predominant, with small and dense nuclei, low cell mass and uneven margins. The bone marrow image of SLE patients is found to be altered because most of the anemia is caused by the disorder of iron metabolism in chronic disease, and the anemia is reduced with the improvement of the primary disease; some of them are iron deficiency, and hemolytic anemia is rare; the proliferation pool and storage pool of bone marrow granulocytes are normal, and the rod nuclei are obviously more than the lobulated nuclei, with an average of 2.7:1; the bone marrow lymphocyte ratio is normal, and the classification of megakaryocytes is similar to that of chronic ITP. E hematocrit reduction was not mainly due to suppression of bone marrow hematopoietic function but to excessive destruction of peripheral blood cells.